Paul Rees: ‘We need a new deal for pharmacy’

EXCLUSIVE Community pharmacy needs a ‘new deal’ that considers estates costs, training time and does not force pharmacies to dispense at a loss, the recently appointed National Pharmacy Association (NPA) chief executive has told The Pharmacist.

In his first interview with The Pharmacist since his appointment in November, Paul Rees spoke about his experience working for membership groups from ramblers to GPs, and the opportunity he sees to influence MPs and media.

Having worked as a journalist at the Evening Standard, The Times and BBC Radio 4 and Radio 5, Mr Rees decided early on in his career that he ‘wanted to help out membership organisations that were doing important work’.

That took him from head of communications at the Ramblers Association, where he led the Right to Roam Campaign, to managing communications for government inquiries and working as a civil servant at the Home Office, where he ‘saw how the government works on the inside’.

But it is his experience of a ‘very successful campaign’ as head of communications at the Royal College of GPs that he hopes will help him achieve similar results for the community pharmacy sector.

‘GPs are contractors who are seen as clinicians, pharmacists are contractors in the same way, but they're seen as an excess cost,’ Mr Rees said.

‘There’s a two-tier approach to the way that pharmacy is managed in comparison with other clinical areas,’ he added, highlighting the fact that the general practice estate and paid learning time for staff is directly funded by the government, while community pharmacy estate and training time is not.

‘It's simply unfair, it’s muddle headed, and it's wrong,’ he told The Pharmacist.

‘While I was at the Royal College of GPs, I was able to raise the issue of the need for more funding for general practice. And that was a very successful campaign.

‘So, I'm hoping that we can use similar a similar approach to make the case for better funding for pharmacy.’

He added: ‘It's really important that the NHS and the government treat pharmacists as the expert clinicians that they are, as opposed to a number on a spreadsheet that they can utilise to try to drive out costs from the system.’

And while ‘putting more money into the system as a stop gap right now’ would be a good thing ‘in the short-term’, Mr Rees suggested that a complete overhaul of the pharmacy contract would be needed.

‘We've got eight pharmacies closing a week [and] we've had 1,000 closed in the last 10 years,’ Mr Rees warned.

‘Last year, we saw a record number of community pharmacies closed in England - 394. If that figure  were replicated this year and next, we would dip below 10,000 community pharmacies for the first time in England since 2006. So essentially, we need a new deal for pharmacy, and that is what the NPA is going to be calling for – a new deal based on a new contract.’

Until a new funding system is implemented ‘there should be a moratorium on clawbacks’, he added.

‘Otherwise, people are buying medications blind, they have no idea whether there'll be a clawback in a few months or a year,’ he told The Pharmacist.

‘Very few other business models are based on such an approach. It's really unfair and a really harsh system to expect professional clinicians to operate in.’

‘There has to be an end to clawbacks. There has to be a total rethink of the funding model because the funding model is broken.’

Mr Rees added: ‘Too many medicines are being dispensed at a loss. Under a new deal, no medicine should be dispensed at a loss.’

In addition to dispensing, Mr Rees wanted to see community pharmacists being paid to deliver clinical services, as well as deprescribing medicines and offering social prescribing.

Pharmacists need a guarantee of future funding for the sector, he said, suggesting that it be set at 2.5% of the NHS budget as it was 10 years ago, rather than the 1.6% it has been reduced to over the last decade.

‘There is the £645 million for Pharmacy First in England but it's not recurrent. No one knows whether that will be there in 2026 or 2027,’ he said.

‘We’re asking community pharmacies to spend money on putting in consulting rooms, to spend time on learning new skills, and new delivery pathways for a system that in two years’ time could be withdrawn from them.

‘We hope that obviously Pharmacy First is here to stay. I think it's what the public wants. We think it is what politicians want. But pharmacists haven't been given any certainty that that is the case.’

Drawing comparisons with other countries, Mr Rees suggested ‘twice the amount’ of the global sum in France was spent on pharmacy, compared with the UK.

‘In France, there's a sustainable network – we want a sustainable network in the UK,’ he added.

The government was contacted for comment.